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Related Experiment Videos

Sublingual capnography: a clinical validation study.

P E Marik1

  • 1Critical Care Medicine, The Mercy Hospital of Pittsburgh, Pittsburgh, PA 15219-5166, USA. pmarik@zbzoom.net

Chest
|September 14, 2001
PubMed
Summary
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Sublingual capnometry (PslCO(2)) closely correlates with gastric tonometry (PimCO(2)) for assessing tissue dysoxia. This noninvasive PslCO(2) measurement offers a simple method for monitoring critically ill patients.

Area of Science:

  • Critical Care Medicine
  • Physiology
  • Medical Technology

Background:

  • Hemodynamic instability in ICU patients often leads to impaired tissue oxygenation.
  • Traditional markers of tissue oxygenation can be invasive or less sensitive to early changes.
  • Gastric intramucosal PCO(2) (PimCO(2)) is an established marker of tissue dysoxia, but requires gastric tonometry.

Purpose of the Study:

  • To compare sublingual PCO(2) (PslCO(2)) measurements with gastric intramucosal PCO(2) (PimCO(2)).
  • To evaluate PslCO(2) and PimCO(2) as indicators of tissue dysoxia.
  • To assess the correlation of PslCO(2) with traditional tissue oxygenation indexes in unstable ICU patients.

Main Methods:

  • Prospective validation study in medical and coronary ICUs.

Related Experiment Videos

  • Inclusion of consecutive patients with severe sepsis, septic shock, or cardiogenic shock.
  • Serial measurements of PslCO(2), PimCO(2), blood lactate, and hemodynamic parameters over 24 hours.

    • Main Results:

    • High correlation between initial PslCO(2) and PimCO(2) measurements (r=0.86, p<0.001).
    • Mean PslCO(2) and PimCO(2) showed strong correlation throughout the study (r=0.78, p<0.001).
    • Initial PslCO(2)-PaCO(2) difference was significantly higher in non-survivors (p=0.04) and correlated with CO(2) gradient.

    Conclusions:

    • Sublingual capnometry (PslCO(2)) provides measurements comparable to gastric tonometry (PimCO(2)).
    • PslCO(2) demonstrates potential as a simple, noninvasive tool for assessing tissue dysoxia.
    • PslCO(2) may aid in monitoring critically ill patients with hemodynamic instability.